As mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020-2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13-1.27), notably in asthma (HR, 2.25; 95% CI, 1.80-2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15-1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68-0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts. 

Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK

Despite the significant psychiatric effects of the COVID-19 pandemic, there's limited data on the prevalence and risk factors of depression and suicide attempts among South Korean adults.A nationwide cross-sectional study using the Korea National Health and Nutrition Examination Survey (KNHANES) data from 1998 to 2021 was conducted. Changes in prevalence and risk factors for depression and suicide attempts were assessed using weighted odds ratios or weighted beta coefficients.During the observation period (1998-2021), the prevalence of depression increased in the overall population; however, no significant surge was found regarding the COVID-19 pandemic, from 2.78% (95% CI, 2.41-3.15) in 1998-2005-4.96% (4.32-5.61) in 2020 and 5.06% (4.43-5.69) in 2021. However, immediately after the onset of the pandemic, younger ages, male sex, urban residence, higher education, and high economic status became significant vulnerable factors compared to pre-pandemic periods. The prevalence of suicide attempts remained stable, and there was no notable surge specifically related to the COVID-19 pandemic, from 0.23% (95% CI, 0.18-0.28) in 1998-2005-0.45% (0.25-0.66) in 2020 and 0.42% (0.24-0.60) in 2021. Furthermore, no distinct vulnerable factors associated with suicide attempts have been identified.Through this nationwide serial cross-sectional survey study, we emphasized the need for understanding the differential impacts of global crises, such as COVID-19, across varied population subgroups, thereby highlighting the importance of specific and targeted mental health support strategies. 

National trends in depression and suicide attempts and COVID-19 pandemic-related factors, 1998-2021: A nationwide study in South Korea.

Psychosocial alterations during the COVID-19 pandemic and the global burden of anxiety and major depressive disorders in adolescents, 1990–2021: challenges in mental health amid socioeconomic disparities

Global public concern of childhood and adolescence suicide: a new perspective and new strategies for suicide prevention in the post-pandemic era

BACKGROUND
Suicide is the second-leading cause of death among adolescents and is associated with clusters of suicides. Despite numerous studies on this preventable cause of death, the focus has primarily been on single nations and traditional statistical methods.


OBJECTIVE
This study aims to develop a predictive model for adolescent suicidal thinking using multinational data sets and machine learning (ML).


METHODS
We used data from the Korea Youth Risk Behavior Web-based Survey with 566,875 adolescents aged between 13 and 18 years and conducted external validation using the Youth Risk Behavior Survey with 103,874 adolescents and Norway's University National General Survey with 19,574 adolescents. Several tree-based ML models were developed, and feature importance and Shapley additive explanations values were analyzed to identify risk factors for adolescent suicidal thinking.


RESULTS
When trained on the Korea Youth Risk Behavior Web-based Survey data from South Korea with a 95% CI, the XGBoost model reported an area under the receiver operating characteristic (AUROC) curve of 90.06% (95% CI 89.97-90.16), displaying superior performance compared to other models. For external validation using the Youth Risk Behavior Survey data from the United States and the University National General Survey from Norway, the XGBoost model achieved AUROCs of 83.09% and 81.27%, respectively. Across all data sets, XGBoost consistently outperformed the other models with the highest AUROC score, and was selected as the optimal model. In terms of predictors of suicidal thinking, feelings of sadness and despair were the most influential, accounting for 57.4% of the impact, followed by stress status at 19.8%. This was followed by age (5.7%), household income (4%), academic achievement (3.4%), sex (2.1%), and others, which contributed less than 2% each.


CONCLUSIONS
This study used ML by integrating diverse data sets from 3 countries to address adolescent suicide. The findings highlight the important role of emotional health indicators in predicting suicidal thinking among adolescents. Specifically, sadness and despair were identified as the most significant predictors, followed by stressful conditions and age. These findings emphasize the critical need for early diagnosis and prevention of mental health issues during adolescence.

Machine Learning-Based Prediction of Suicidal Thinking in Adolescents by Derivation and Validation in 3 Independent Worldwide Cohorts: Algorithm Development and Validation Study.

Importance Only a few studies have examined the long-term trends of hand and oral hygiene, especially among adolescents. Objective To investigate the 15-year trends in frequency of handwashing and toothbrushing and examine the factors associated with hand and oral hygiene, particularly during the COVID-19 pandemic. Design, Setting, and Participants This cross-sectional study, performed from January 1, 2008, to December 31, 2022, used general population–based data from 963 644 individuals in a national representative survey (Korea Youth Risk Behavior Web-based Survey [KYRBS]). Exposure COVID-19 pandemic. Main Outcomes and Measures Trends in hand and oral hygiene practices were measured by how frequently adolescents washed their hands and whether they fulfilled the recommended guidelines for toothbrushing. An interrupted time series analysis using linear and logistic regression models was performed to assess any associations with the COVID-19 pandemic. Hand and oral hygiene behaviors before and during the pandemic in each sociodemographic subgroup were also compared. Results In the 963 644 adolescents (495 697 [51.4%] male; mean [range] age, 15.01 [12-18] years) who participated in the KYRBS from 2008 to 2022, a 73.3% (95% CI, 59.4%-97.4%; P &amp;amp;lt; .001) immediate increase was seen in overall hand hygiene behavior at the onset of the COVID-19 pandemic compared with the prepandemic period, with a sustained decrease thereafter (β = −0.018; 95% CI, −0.022 to −0.015; P &amp;amp;lt; .001). Meanwhile, no immediate increase was observed in terms of overall oral hygiene behavior (0.1%; 95% CI, −0.9% to 1.1%; P = .82); however, there was a sustained decrease during the pandemic (β = −0.018; 95% CI, −0.020 to −0.016; P &amp;amp;lt; .001). Older age, female sex, nonsmoking status, alcohol use, low household economic level, and poor school performance were significantly associated with poor hand hygiene during the pandemic. Conclusions and Relevance In this cross-sectional study of South Korean adolescents, an increase in the prevalence of hand hygiene was observed during the early pandemic; however, this prevalence decreased over time. Meanwhile, the decrease in the prevalence of oral hygiene was more pronounced during the pandemic. This study recommends stronger guidelines for adolescent health coaches, such as teachers or public health advisers, regarding hygiene behaviors, even after the COVID-19 pandemic ends. 

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

National trends in prevalence of sadness, counseling for sadness, and sleep time among Koreans amid pandemic, 2009-2021: a nationwide representative study of over 2.8 million individuals

Objectives The purpose of this study is to present a presentation class using PBL in the Gather.town environment for intermediate academic purpose learners and to propose the educational applicability of the Gather.town environment. 
Methods For this purpose, the established PBL was reorganized into problem presentation-problem solving- presentation and evaluation stages to suit presentation classes in Gather.town environment, and a Gather.town map was designed, and 18 international students currently attending Korean universities and graduate schools were recruited. A total of eight classes were conducted for two weeks. A questionnaire was organized with questions about the presentation class and the class in the Gather.town environment, and a questionnaire was conducted for learners participating in the class afterward. All of the questions in the survey were answered on a Likert scale except for the last question. 
Results As a result of the survey, motivation, upturn of reality, and increase in interaction were derived as the advantages of classes using Gather.town. In particular, it was confirmed that interest in the ‘presentation’ class and self-efficacy can be promoted in the process of solving problems through cooperative activities in classes to improve presentation skills. 
Conclusions This study is meaningful in that it suggested the possibility of applying the Metaverse’ Korean education, a new educational environment, by designing and applying classes centered on the problem-solving process of “presentation” that international students face difficulties in using Gather.town. According to this study, it is expected that various educational attempts for international students based on the Metaverse environment will be expanded.

A Case Study on the Korean Presentation Class Plan for International Student Using Gather.town: Based on Problem Based Learning

Abstract Studies on the trends in the prevalence of rheumatoid arthritis (RA) and osteoarthritis (OA) are limited, particularly during the COVID-19 pandemic. This study aimed to analyze the temporal trend of RA and OA in South Korean adults from 1998 to 2021, including the COVID-19 pandemic period. The Korea National Health and Nutrition Examination Survey (KNHANES) data on adults aged ≥ 19 years were analyzed to investigate the prevalence of RA and OA from 1998 to 2021. The prevalence trends were compared by the years, and β diff (β difference) was calculated. Odds ratios (ORs) were computed for each disease to examine changes in disease prevalence before and during the pandemic in order to determine the impact of the pandemic on disease prevalence. Among 163,221 Korean adults, the prevalence of RA and OA showed a steady decrease from 2005 (RA: from 1.91% in 2005–2007 to 1.55% in 2016–2019 and OA: from 9.75% in 2005–2007 to 8.27% in 2016–2019), but there was a slight increased after the onset of the COVID-19 pandemic (RA: from 1.23% in 2020 to 1.36% in 2021 and OA: from 8.04% in 2020 to 8.27% in 2021). Vulnerable groups, including participants aged ≥ 60 years (versus 19–60 years, ratio of ORs: 1.222; 95% CI 1.011–1.477), urban residents (ratio of ORs: 1.289; 95% CI 1.007–1.650), and participants with higher education level (ratio of ORs: 1.360; 95% CI 1.119–1.653) showed higher ORs of OA, whereas no particularly vulnerable population was observed for RA. Our findings provide an insight into the long-term trends of RA and OA among adult population and highlight a novel perspective on the impact of COVID-19 on disease prevalence. 

National trends in rheumatoid arthritis and osteoarthritis prevalence in South Korea, 1998–2021

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Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

National trends in prevalence of sadness, counseling for sadness, and sleep time among Koreans amid pandemic, 2009-2021: a nationwide representative study of over 2.8 million individuals

A Case Study on the Korean Presentation Class Plan for International Student Using Gather.town: Based on Problem Based Learning

National trends in rheumatoid arthritis and osteoarthritis prevalence in South Korea, 1998–2021